Advice to My Intern Self

Rosy Thachil, MD


July 12, 2021

Overcaffeinated and donning my new long white coat that said "MD" (undoubtedly too long on my petite frame), I stared at the dauntingly long patient list in front of me. I wondered how in the world I was going to gather all the appropriate data before 9 AM rounds. I wished I could clone myself three times over.

First day of intern year.
First day of fellowship.
First day of attendingship.

These are all days that for me invoked equal parts excitement, anxiety, and accomplishment.

As an early-career attending physician, memories of my own residency and fellowship are still fairly fresh. When I reflect on these years, though they were grueling at times, they were also incredibly transformative — a true rite of passage and an experience that bonds us as physicians.

Here are a few kernels of wisdom that I received during my training and hope to pass on to new and current trainees:

  1. Adopt a growth mindset. Be open, inquisitive, and engaged. Learn from the seniors, nurses, and other staff, and don't hesitate to ask questions (remember, the great will never make you feel small). It is normal to have more questions than answers during intern year.

  2. Fail forward. Maybe you didn't succeed in placing the central line on the first try, or maybe you didn't know the answer to a question on rounds. In the moment, these feel like significant failures because we as medical professionals can often be our harshest critics. Try to learn and grow from these experiences. Remember, FAIL = First Attempt In Learning.

  3. Imposter syndrome is real. You feel as though you should know so much more. "Did I even learn anything in med school?" Rest assured that many are feeling the same way, and with enough time and practice, you will acquire the necessary skills. Asking for help is not a sign of weakness.

  4. Observe and listen actively. Clinical medicine is art. You will pick up skills, approaches, and clinical acumen simply by watching others.

  5. Have a system to stay organized. For me it was printing the service list/signout, writing down labs, and creating a checklist of things to do. Everyone is different, but find a system that will consistently work for you.

  6. There will be tough days. On a particularly overwhelming day early in my internship, there were numerous new admissions, many complicated patients to be rounded upon, and a pager that wouldn't stop beeping. I remember my senior resident telling me, "No one can stop time, the day will eventually end, and tomorrow is a new day." This sentiment has always stuck with me. There will be trying days, but they won't last forever, and you will learn a great deal from them.

  7. Start thinking about career trajectory. Do you want to specialize? Do you want to be academic vs entering private practice? Do you want to conduct research? Start soul-searching and exploring.

  8. Find a mentor/sponsor. If you find yourself gravitating toward a particular specialty, find a mentor within that field. This should be someone who can potentially help you navigate the fellowship application process, and also someone that you can bounce ideas and thoughts off of.

  9. Find your tribe. Build camaraderie. Your co-interns/residents/fellows will be a great source of support during training. Moreover, some of these individuals will become lifelong friends and future colleagues.

  10. Learn a bit about personal finance. It's not taught in school, but it's something that I wish I had started learning about during residency. This book is a great primer.

  11. Remember to take care of the caregiver — ie, yourself. In my previous article, I discussed compassion fatigue, a very real phenomenon. Training can make you particularly vulnerable to this. Though training is demanding, try to find time to exercise, make healthy dietary choices, and spend time with hobbies, family, and friends.

Most important, at the risk of sounding trite, remember to enjoy the process. It is in these points of transition that we experience the most growth.

Medical training only happens once, and moments during these years will turn into memories that you will reflect fondly on in hindsight. Medical training may be associated with some sweat and tears, but it is also rich in memories, friendships, and transformation.

What are your tips and stories from intern year, residency, and fellowship? Please share them below.

Disclaimer: The above article is intended for informational purposes only. It is not professional medical advice. If you believe you may have a medical emergency, immediately call your physician or 911.

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About Dr Rosy Thachil
Rosy Thachil, MD, is a noninvasive cardiologist and assistant professor of medicine at Albert Einstein College of Medicine. She is a graduate of Jefferson Medical College and completed cardiology training at Mount Sinai Hospital. She is a fellow of the American College of Cardiology.

Dr Thachil's clinical interests including acute cardiovascular care, cardiac critical care, and health disparities. Her nonclinical interests include personal development, blogging, and writing (at


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